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Employers and Health Plans Bet on Health and Wellness Initiatives to Stem Costs

News Release
June 4, 2008

Alwyn Cassil (202) 264-3484 or

WASHINGTON, DC—Health plan initiatives to promote health and wellness among workers are now commonplace, despite an acknowledged lack of evidence of an investment payoff, according to a study released today by the Center for Studying Health System Change (HSC).

Much of the momentum for health and wellness initiatives has come from large employers looking for long-term strategies to address rising costs and to support their broader consumer-based strategy of giving employees more responsibility for health care decisions and costs, the study found.

The investment payoff for health and wellness initiatives has been difficult to demonstrate, according to the study. Because many of the health and wellness activities in existence today have only been introduced recently and not yet evaluated, there is little credible evidence regarding return on investment.

"Ultimately, the credibility of health and wellness activities to improve health and contain costs will depend on evidence demonstrating both health improvements and a positive return on investment," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded in part by the Robert Wood Johnson Foundation.

"We heard from employers and health plans that health and wellness activities are the right thing to do and are particularly important as employees assume more responsibility for health care decisions and costs," said HSC Senior Fellow Debra A. Draper, Ph.D., coauthor of the study with HSC Health Researcher Ann Tynan, M.P.H., and HSC Senior Consulting Researcher Jon B. Christianson, Ph.D., of the University of Minnesota.

Health and wellness activities are premised on the idea that healthier people will use fewer medical resources and be more productive. Health and wellness initiatives go beyond screening activities, such as mammograms and colonoscopies that detect disease, and differ from disease management and case management interventions, which are used once a disease is diagnosed.

The study’s findings are detailed in a new HSC Issue Brief—Health and Wellness Initiatives: The Shift from Managing Illness to Promoting Healthavailable here.
The study is based on HSC’s 2007 site visits to 12 nationally representative metropolitan communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking change in these markets since 1996. The site-visit research is funded by the Robert Wood Johnson Foundation.

Other key study findings include:

  • Across the 12 HSC communities, health plans are packaging, branding and marketing health and wellness activities as a way of differentiating themselves in the market. Often these activities are marketed as a key component of a comprehensive approach to care management.
  • Engaging enrollees is challenging because participation in health and wellness activities typically is voluntary. Most respondents believed some type of incentive is needed to engage people-not only to get them involved initially, but also to encourage them to actually improve their health. Where incentives exist, they tend to vary widely in size and design. They include, for example, small cash payments for the completion of a health risk assessment, gift cards, discounts off of gym memberships, and reimbursement for weight management programs, such as Weight Watchers.
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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.


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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.